There was an optional Gift Swap, we swapped and had the option to “steel” gifts from each other

ICE BREAKER: Share (if you would like to) one tradition that you have currently, or had in your childhood that is special to you at the holidays

TOPIC: New state mandates that apply to NJ for treatment of Chronic and Acute pain with Opioids. NEW JERSEY passed very agressive law to try to deal with the Opiate Crisis

Many of us with chronic illness and chronic pain will require one if not multiple surgeries throughout our lifetime. So, our chronic pain management can quickly turn into an Acute Pain management problem. Things have drastically changed such that many surgeons are now planning ahead with their patients and putting them in touch with a pain management specialist so that they themselves are not getting involved with writing for narcotics.

Many members were feeling like these new rules are not really going to help deter people who are going to abuse narcotics (either by over-taking them, or by diverting (selling) them). And that they pose an unnecessary hardship to those who are on long term narcotic therapy legally and rightfully.

Here is a copy of the presentation along with the links to direct you to the information:

Perdu Pharma was pushing opiates in the 1990’s as being “safer” than other meds used to address chronic pain.

Since narcotics are highly addictive, people on long term opiod therapy are 40X more likely to get addicted to Heroine.

in 2017 a bill unanimously passed in NJ regarding FIRST SCRIPT for narcotics dropping that initial script from 30 days down to a max. of 5 days. This pertains mostly to ACUTE pain or new onset of injury/illness

* The five day rule there is no exceptions, not even surgery

* For surgery they must prescribe the lowest dosage of immediate release they can * "New script” is defined as not having been prescribed the med for a year!

It also gave the green light for 180 day treatment for patients addicted to painkillers without preauthorization if doctor recommended.

In this article about the bill, it states “state laws that will limit the ability of doctors to make certain types of prescriptions.”

So which patients are exempt from these stringent rules:

Cancer

Hospice/palliative care

Long term Care facility

MAT program (medication assisted treatment for drug rehab)

(not sure where that puts people with chronic illness such as autoimmune diseases/Fibromyalgia or Chronic Fatigue Syndrome/ME)

After the 5th day the Dr. can write a new script for 30 days BUT you either have to go in person to pick up the script, or he has to electronically send it through the system.

MANY OF US WITH AUTOIMMUNE REQUIRE SURGERY (OR MULTIPLE SURGERIES THROUGHOUT OUR ILLNESS:

In an emergency where you can’t get in post-op and your doctor doesn’t have e-fill he can call in a 72 hour emergency prescription and then back it up within 7 days with a written order to the pharmacist. But that only buys you 3 days.

By the 3rd prescription you will likely be referred to a pain management specialist for “chronic” treatment

Any doctor prescribing must add a note to your chart that they discussed risks of developing addiction and optional meds/modalities.

BTW, for the 5 day fill, most insurance companies can charge you the 30 day price even if they pro-rate the 5 days worth of pills. You probably would have to pay it and then try for reimbursement of the 25 days after the fact.

So on to CHRONIC PAIN – defined as 3 months or more

* You will need a minimum of one doctor visit Q3 mo * Or before any refill so if you refill monthly, it will be monthly * Dr will need to make reasonable efforts to stop or decrease your meds or to try other modalities unless contraindicated, such as:

- Relaxation, physical therapy, psychological therapy, exercise, other meds * There must be a written PAIN AGREEMENT signed by you (probably annually) * They have the right to employ drug screens and/or pill counts at random to check for compliance

Doctors will now be required to have 1 cr per 100 education credits for biennial license renewal. (ARE YOU KIDDING ME??? ONE CREDIT???)

* Must be cross-checked by doctor before every refill * Must be reviewed quarterly for signs of misuse * Must be checked by pharmacist prior to filling the script each timeObviously for Schedule II drugs there are no “refills”. Each script must be a new written script.

* No refills for Schedule 2s, new written script every time * Partial fill must be completed within 72 hours or need new script. They must advise you * If you are not due to be filled yet, the Pharmacistr can legally hold your script to prevent you from taking it elsewhere. They have the right to hold it until the day it should be filled or they can send it back to your dr. with a note explaining why

DEA has new goal to reduce the number of opioid prescriptions by 1/3 over 3 years.

This includes a 10% reduction of manufacturing of the top 6 opiate meds for 2019 over 2018 (stating that it potentially reduces the # of pills diverted for trafficking. (this presumes that quite a few people out there are selling their meds instead of using them) schedule II opioids, including oxycodone, hydrocodone, oxymorphone, hydromorphone, morphine, and fentanyl:

Wishing You ALL A Happy and HEALTHY Holiday Season!!! See you in the New Year!!!

NEXT MEETING: Saturday, January 12th, 2019 (then feb 9)

PS. Mark your calendar now for the March 9th meeting, as we are having a Guest Speaker come speak to us for approx 1/2 hr about Disability Insurance, come listen and get your questions answered!